1887
Euroroundup Open Access
Like 0

Abstract

The public health implications of hepatitis E virus (HEV) in Europe have changed due to increasing numbers of hepatitis E cases and recent reports of chronic, persistent HEV infections associated with progression to cirrhosis in immunosuppressed patients. The main infectious risk for such immunosuppressed patients is exposure to undercooked infected pork products and blood transfusion. We summarised the epidemiology of HEV infections among blood donors and also outlined any strategies to prevent transfusion-transmitted HEV, in 11 European countries. In response to the threat posed by HEV and related public and political concerns, most of the observed countries determined seroprevalence of HEV in donors and presence of HEV RNA in blood donations. France, Germany, Spain and the United Kingdom (UK) reported cases of transfusion-transmitted HEV. Ireland and the UK have already implemented HEV RNA screening of blood donations; the Netherlands will start in 2017. Germany and France perform screening for HEV RNA in several blood establishments or plasma donations intended for use in high-risk patients respectively and, with Switzerland, are considering implementing selective or universal screening nationwide. In Greece, Portugal, Italy and Spain, the blood authorities are evaluating the situation. Denmark decided not to implement the HEV screening of blood donations.

Loading

Article metrics loading...

/content/10.2807/1560-7917.ES.2017.22.16.30514
2017-04-20
2024-12-21
/content/10.2807/1560-7917.ES.2017.22.16.30514
Loading
Loading full text...

Full text loading...

/deliver/fulltext/eurosurveillance/22/16/eurosurv-22-30514-2.html?itemId=/content/10.2807/1560-7917.ES.2017.22.16.30514&mimeType=html&fmt=ahah

References

  1. Barnaud E, Rogée S, Garry P, Rose N, Pavio N. Thermal inactivation of infectious hepatitis E virus in experimentally contaminated food. Appl Environ Microbiol. 2012;78(15):5153-9.  https://doi.org/10.1128/AEM.00436-12  PMID: 22610436 
  2. Perez-Gracia MT, Garcia M, Suay B, Mateos-Lindemann ML. Current Knowledge on Hepatitis E. J Clin Transl Hepatol. 2015;3(2):117-26.
  3. Schlosser B, Stein A, Neuhaus R, Pahl S, Ramez B, Krüger DH, et al. Liver transplant from a donor with occult HEV infection induced chronic hepatitis and cirrhosis in the recipient. J Hepatol. 2012;56(2):500-2.  https://doi.org/10.1016/j.jhep.2011.06.021  PMID: 21798217 
  4. Nelson KE, Kmush B, Labrique AB. The epidemiology of hepatitis E virus infections in developed countries and among immunocompromised patients. Expert Rev Anti Infect Ther. 2011;9(12):1133-48.  https://doi.org/10.1586/eri.11.138  PMID: 22114964 
  5. Adlhoch C, Avellon A, Baylis SA, Ciccaglione AR, Couturier E, de Sousa R, et al. Hepatitis E virus: Assessment of the epidemiological situation in humans in Europe, 2014/15. J Clin Virol. 2016;82:9-16.  https://doi.org/10.1016/j.jcv.2016.06.010  PMID: 27393938 
  6. Kamar N, Dalton HR, Abravanel F, Izopet J. Hepatitis E virus infection. Clin Microbiol Rev. 2014;27(1):116-38.  https://doi.org/10.1128/CMR.00057-13  PMID: 24396139 
  7. Hogema BM, Molier M, Sjerps M, de Waal M, van Swieten P, van de Laar T, et al. Incidence and duration of hepatitis E virus infection in Dutch blood donors. Transfusion. 2016;56(3):722-8.  https://doi.org/10.1111/trf.13402  PMID: 26559806 
  8. Hewitt PE, Ijaz S, Brailsford SR, Brett R, Dicks S, Haywood B, et al. Hepatitis E virus in blood components: a prevalence and transmission study in southeast England. Lancet. 2014;384(9956):1766-73.  https://doi.org/10.1016/S0140-6736(14)61034-5  PMID: 25078306 
  9. Baylis SA, Koc O, Nick S, Blümel J. Widespread distribution of hepatitis E virus in plasma fractionation pools. Vox Sang. 2012;102(2):182-3.  https://doi.org/10.1111/j.1423-0410.2011.01527.x  PMID: 21806631 
  10. European Medicines Agency (EMA). Reflection paper on viral safety of plasma-derived medicinal products with respect to hepatitis E virus. London: EMA; 23 Jun 2016. Available from: http://www.ema.europa.eu/docs/en_GB/document_library/Scientific_guideline/2016/06/WC500209354.pdf
  11. Tedder RS, Ijaz S, Kitchen A, Ushiro-Lumb I, Tettmar KI, Hewitt P, et al. Hepatitis E risks: pigs or blood-that is the question. Transfusion. 2017;57(2):267-72.  https://doi.org/10.1111/trf.13976  PMID: 28194857 
  12. Dalton HR, Kamar N. Treatment of hepatitis E virus. Curr Opin Infect Dis. 2016;29(6):639-44.  https://doi.org/10.1097/QCO.0000000000000316  PMID: 27607911 
  13. The European Directorate for the Quality of Medicines and HealthCare (EDQM). European Pharmacopoeia 8th edition; Strasbourg: Council of Europe; 2016.
  14. Breum SO, Hjulsager CK, de Deus N, Segalés J, Larsen LE. Hepatitis E virus is highly prevalent in the Danish pig population. Vet Microbiol. 2010;146(1-2):144-9.  https://doi.org/10.1016/j.vetmic.2010.05.002  PMID: 20554125 
  15. Holm DK, Moessner BK, Engle RE, Zaaijer HL, Georgsen J, Purcell RH, et al. Declining prevalence of hepatitis E antibodies among Danish blood donors. Transfusion. 2015;55(7):1662-7.  https://doi.org/10.1111/trf.13028  PMID: 25819381 
  16. Harritshøj LH, Holm DK, Saekmose SG, Jensen BA, Hogema BM, Fischer TK, et al. Low transfusion transmission of hepatitis E among 25,637 single-donation, nucleic acid-tested blood donors. Transfusion. 2016;56(9):2225-32.  https://doi.org/10.1111/trf.13700  PMID: 27385646 
  17. The Danish Society of Clinical Immunology. Udvalg vedrørende transfusionsoverførte infektioner, 2015. [Committee for transfusion-transmitted infections, 2015]. Danish. [Accessed 1 Apr 2017]. Available from: http://dski.dk/files/%C3%85rsberetning-for-smitteudvalget-2015.pdf
  18. Gallian P, Lhomme S, Piquet Y, Sauné K, Abravanel F, Assal A, et al. Hepatitis E virus infections in blood donors, France. Emerg Infect Dis. 2014;20(11):1914-7.  https://doi.org/10.3201/eid2011.140516  PMID: 25340881 
  19. Mansuy JM, Gallian P, Dimeglio C, Saune K, Arnaud C, Pelletier B, et al. A nationwide survey of hepatitis E viral infection in French blood donors. Hepatology. 2016;63(4):1145-54.  https://doi.org/10.1002/hep.28436  PMID: 27008201 
  20. Hauser L, Roque-Afonso AM, Beylouné A, Simonet M, Deau Fischer B, Burin des Roziers N, et al. Hepatitis E transmission by transfusion of Intercept blood system-treated plasma. Blood. 2014;123(5):796-7.  https://doi.org/10.1182/blood-2013-09-524348  PMID: 24482503 
  21. Féray C, Pawlotsky JM, Roque-Afonso AM, Samuel D, Dhumeaux D. Should we screen blood products for hepatitis E virus RNA? Lancet. 2014;383(9913):218.  https://doi.org/10.1016/S0140-6736(14)60072-6  PMID: 24439737 
  22. Baylis SA, Gärtner T, Nick S, Ovemyr J, Blümel J. Occurrence of hepatitis E virus RNA in plasma donations from Sweden, Germany and the United States. Vox Sang. 2012;103(1):89-90.  https://doi.org/10.1111/j.1423-0410.2011.01583.x  PMID: 22220775 
  23. Vollmer T, Diekmann J, Johne R, Eberhardt M, Knabbe C, Dreier J. Novel approach for detection of hepatitis E virus infection in German blood donors. J Clin Microbiol. 2012;50(8):2708-13.  https://doi.org/10.1128/JCM.01119-12  PMID: 22675127 
  24. Müller B, Koch HLP. PCR-Screening of blood donations for hepatitis E with the cobas HEV test performed on the new Roche cobas 8800 platform in minipools of 6. Transfus Med Hemother. 2015;42(suppl 1):1-64.
  25. Paul-Ehrlich-Institut (PEI). Hämovigilanz-Bericht. [Hemovigilance report]. Langen: PEI. [Accessed Oct 2016]. German. Available from: http://www.pei.de/DE/arzneimittelsicherheit-vigilanz/haemovigilanz/haemovigilanzberichte/haemovigilanzberichte-node.html.
  26. Bettinger D, Schorb E, Huzly D, Panning M, Schmitt-Graeff A, Kurz P, et al. Chronic hepatitis E virus infection following allogeneic hematopoietic stem cell transplantation: an important differential diagnosis for graft versus host disease. Ann Hematol. 2015;94(2):359-60.  https://doi.org/10.1007/s00277-014-2163-4  PMID: 25015055 
  27. Pauli G, Aepfelbacher M, Bauerfeind U, Blümel J, Burger R, Gärtner B, et al. Hepatitis E Virus. Transfus Med Hemother. 2015;42(4):247-65.  https://doi.org/10.1159/000431191  PMID: 26557817 
  28. Zervou EZ, Politis CP, Hassapopoulou EH, Vini MV, Parara MP, Kavallierou LK, et al. Prevalence of hepatitis e virus (HEV) infection in blood donors and multi-transfused patients in Greece. Vox Sang. 2015;109 (Suppl 1), P-425:242-3.
  29. O’Riordan J, Boland F, Williams P, Donnellan J, Hogema BM, Ijaz S, et al. Hepatitis E virus infection in the Irish blood donor population. Transfusion. 2016;56(11):2868-76.  https://doi.org/10.1111/trf.13757  PMID: 27522065 
  30. Stroffolini T, Menchinelli M, Dambruoso V, Menniti Ippolito F, Costantino A, Rapicetta M, et al. Prevalence of hepatitis E in a central Italian town at high endemicity for hepatitis C virus. Ital J Gastroenterol. 1996;28(9):523-5. PMID: 9131399 
  31. Rapicetta M, Kondili LA, Pretolani S, Stroffolini T, Chionne P, Villano U, et al. Seroprevalence and anti-HEV persistence in the general population of the Republic of San Marino. J Med Virol. 1999;58(1):49-53.  https://doi.org/10.1002/(SICI)1096-9071(199905)58:1<49::AID-JMV7>3.0.CO;2-C  PMID: 10223545 
  32. Gessoni G, Manoni F. Hepatitis E virus infection in north-east Italy: serological study in the open population and groups at risk. J Viral Hepat. 1996;3(4):197-202.  https://doi.org/10.1111/j.1365-2893.1996.tb00095.x  PMID: 8871881 
  33. Vulcano A, Angelucci M, Candelori E, Martini V, Patti AM, Mancini C, et al. HEV prevalence in the general population and among workers at zoonotic risk in Latium Region. Ann Ig. 2007;19(3):181-6. PMID: 17658105 
  34. Pavia M, Iiritano E, Veratti MA, Angelillo IF. Prevalence of hepatitis E antibodies in healthy persons in southern Italy. Infection. 1998;26(1):32-5.  https://doi.org/10.1007/BF02768749  PMID: 9505177 
  35. De Donno A, Chironna M, Craca R, Paiano A, Zizza A, Guido M, et al. [Anti-HEV seroprevalence in the area of Lecce]. Ann Ig. 2003;15(3):199-205. PMID: 12910873 
  36. Scotto G, Martinelli D, Centra M, Querques M, Vittorio F, Delli Carri P, et al. Epidemiological and clinical features of HEV infection: a survey in the district of Foggia (Apulia, Southern Italy). Epidemiol Infect. 2014;142(2):287-94.  https://doi.org/10.1017/S0950268813001167  PMID: 23673019 
  37. Epicentro. Il portale dell'epidemiologia per la sanità pubblica. Epatite virale. Aspetti epidemiologici in Italia. [Viral hepatitis. Epidemiological aspects in Italy]. Rome: Istituto superiore di sanità; 2015. Italian. Available from: http://www.Epicentro.Iss.It/problemi/epatite/epidemiologiaitalia.Asp
  38. Lucarelli C, Spada E, Taliani G, Chionne P, Madonna E, Marcantonio C, et al. High prevalence of anti-hepatitis E virus antibodies among blood donors in central Italy, February to March 2014. Euro Surveill. 2016;21(30):30299.  https://doi.org/10.2807/1560-7917.ES.2016.21.30.30299  PMID: 27494608 
  39. Rijksinstituut voor Volksgezondheid en Milieu (RIVM). Signaal 2854: 'Hepatitis E-virus-RNA in diverse varkensleverproducten', Signaleringsoverleg 23 juni 2016 (week 25). Alert 2854: 'Hepatitis E virus-RNA in various pig liver products', Alert discussion, 23 Jun 2016 (Week 25). Bilthoven: RIVM. Dutch. [Accessed April 2017]. Available from: http://rivm-lci.m13.mailplus.nl/genericservice/code/servlet/React?encId=9vRn24CiVmfDuRp&actId=507413&command=openhtml
  40. HEPeCONTROL. Hepatitis E Virus Epidemiology, Safety and Control 2015 [cited 2017]. Available from: http://hepecontrol-eng.weebly.com/.
  41. Mesquita JR, Myrmel M, Stene-Johansen K, Øverbø J, Nascimento MSJ. A Public Health initiative on hepatitis E virus epidemiology, safety and control in Portugal--study protocol. BMC Infect Dis. 2016;16(1):17.  https://doi.org/10.1186/s12879-016-1341-5  PMID: 26774897 
  42. Riveiro-Barciela M, Sauleda S, Quer J, Salvador F, Gregori J, Pirón M, et al. Red blood cell transfusion-transmitted acute hepatitis E in an immunocompetent subject in Europe: a case report. Transfusion. 2017;57(2):244-7.  https://doi.org/10.1111/trf.13876  PMID: 27785789 
  43. Schnegg A, Bürgisser P, André C, Kenfak-Foguena A, Canellini G, Moradpour D, et al. An analysis of the benefit of using HEV genotype 3 antigens in detecting anti-HEV IgG in a European population. PLoS One. 2013;8(5):e62980.  https://doi.org/10.1371/journal.pone.0062980  PMID: 23667554 
  44. Gottschalk J, Hardegger K, Darnuzer R, Frey BM. Seroprevalence of Hepatitis E virus in Swiss blood donors originating from the canton of Zürich. Interlaken: SGM-Jahrestagung; 2013. [Accessed April 2017]. Available from: http://www.blutspendezurich.ch/Media/File/Archiv%20div.%20Daten/HEV%20SGM%202013%20Kompatibilit%C3%A4tsmodus.pdf
  45. Niederhauser C, Widmer N, Hotz M, Gowland P. Seroprevalence of Hepatitis E virus (HEV) in the Swiss blood donors: Basis for future strategy for preventing HEV transmission to at risk individuals. Vox Sang. 2016; 111 (suppl 1):305 (P240).
  46. Advisory Committee on Safety of Blood, Tissues, and Organs. Minutes of the Extraordinary Meeting 7th July 2015. London; 2015. Available from: https://app.box.com/s/m6or0zdspah90u6kg3r9/1/4217161119/34764863333/1
  47. Expert advisory committee on the Safety of Blood, Tissues and Organs (SaBTO). Recommendations from the expert advisory committee on the Safety of Blood, Tissues and Organs, on measures to protect patients from acquiring hepatitis E virus via transfusion and transplantation. London: SaBTO; 1 Nov 2016. Available from: https://app.box.com/s/m6or0zdspah90u6kg3r9/1/14460576146/113700100341/1
  48. Berto A, Backer JA, Mesquita JR, Nascimento MS, Banks M, Martelli F, et al. Prevalence and transmission of hepatitis E virus in domestic swine populations in different European countries. BMC Res Notes. 2012;5(1):190.  https://doi.org/10.1186/1756-0500-5-190  PMID: 22534364 
  49. Agriculture and Horticulture Development Board (AHDB). EU pig meat consumption rises in 2015. Warwickshire: AHDB; [Accessed Sep2016]. Available from: http://pork.ahdb.org.uk/prices-stats/news/2016/march/eu-pig-meat-consumption-rises-in-2015/
  50. Passweg JR, Baldomero H, Bader P, Bonini C, Cesaro S, Dreger P, et al. Hematopoietic stem cell transplantation in Europe 2014: more than 40 000 transplants annually. Bone Marrow Transplant. 2016;51(6):786-92.  https://doi.org/10.1038/bmt.2016.20  PMID: 26901709 
  51. European Directorate for the Quality of Medecines and Healthcare (EDQM). Newsletter transplant 2015. Strasbourg: Council of Europe; 2015. Available from: https://www.edqm.eu/sites/default/files/newsletter_transplant_volume_21_september_2016.pdf
  52. Sauleda S, Ong E, Bes M, Janssen A, Cory R, Babizki M, et al. Seroprevalence of hepatitis E virus (HEV) and detection of HEV RNA with a transcription-mediated amplification assay in blood donors from Catalonia (Spain). Transfusion. 2015;55(5):972-9.  https://doi.org/10.1111/trf.12929  PMID: 25403913 
/content/10.2807/1560-7917.ES.2017.22.16.30514
Loading

Data & Media loading...

Submit comment
Close
Comment moderation successfully completed
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error